Level II EV Charger Rebate Form

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$500 rebate not to exceed 50% of the cost of the level 2 charger.
Member Information

Equipment Location Information

Level II Charger Installation and Equipment Information
Charger Information

Attach Charger Invoice and Specification Sheet
Rebate: 50% of charger cost up to $500
Recommended Charge Time 10PM-7AM
Electric Vehicle

(Calculated field)
Please make sure to program your vehicle so it will not charge during the peak period of 4-9 PM whenever possible. This will help keep costs down for your Cooperative.
Terms and Conditions - Level II Charger
Level II Charger Requirements
Rebate is for a Level II charger requiring a 240/208 volt input supply. Rebate amount shown is maximum and is limited to 50% of the charger equipment cost without installation. Member must sign load control agreement. EV charging stations that receive rebates may be subject to cooperative load control programs or a time of use rate. The participant agrees to allow the cooperative to control the timing of their charging equipment now or in the future. This
offer is only for residential customers and is limited to one charger per home. The primary location of the charging unit must be at the address provided on this form and served by the Cooperative. It is recommended that a qualified electrician complete the installation and verify the panel is large enough to accommodate the charger. Member ownership or lease of licensed plug-in vehicle (PEV) or hybrid electric vehicle (PHEV) is required. Chargers for non-licensed utility, golf cart, off -road or other recreational vehicles are not eligible. May be subject to verification by MPC.

Please make sure to program your vehicle so it will not charge during the peak period of 4-9 PM whenever possible. This will help keep costs down for your Cooperative.

General Terms and Conditions
The Cooperative must supply all electricity to the equipment for which the rebate is being paid.

Application Information:
Missing or incorrect information on the application may delay processing and delivery of the rebate. An invoice is required and should include specific product information, including the brand, model, serial number and date of purchase of the energy efficient measures. Other information including manufacturer's equipment performance sheets may be required upon request.

The Cooperative reserves the right to verify sales transactions and to have reasonable access to the Member's facility to inspect preexisting equipment (if applicable) and energy efficient measures
installed under this program.

Warranty Information: The Cooperative makes no warranties, expressed or implied, with respect to equipment operation, material, workmanship or manufacturing. The Cooperative does not guarantee that a certain level of energy or cost savings will result from the use of products covered by this program.

Limitation of Liability: The Cooperative's liability in connection with this program is limited to paying the rebate specified when all terms and conditions have been satisfied. Under no circumstances shall the Cooperative be liable for any consequential or incidental damages or tax liability resulting from participation in this program.

Participant Certification: Participating Member certifies that he/she purchased and installed the equipment listed on their application at the defined location served by the Cooperative. The
Member agrees that all information provided is true and that he/she has conformed to all program requirements. If the equipment and application does not comply with the Cooperative's rules and
qualifications, the rebate amount may be denied or adjusted.

Program Changes/Termination: The Cooperative reserves the right to extend, modify (including incentive levels) or terminate this Program at any time without prior or further notice. The Member is responsible for checking with the Cooperative to determine whether the program has been changed or is still in effect.

Members must apply for rebates within six (6) months of the purchase date (as shown on the Member's invoice). Past eligibility, however, does not guarantee that equipment will meet criteria for current programs in effect.